Association between quetiapine use and self-harm outcomes among people with recorded personality disorder in UK primary care: A self-controlled case series analysis


Journal article


J. Hayes, S. Hardoon, J. Deighton, E. Viding, D. Osborn
Journal of Psychopharmacology, 2022

Semantic Scholar DOI PubMedCentral PubMed
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APA   Click to copy
Hayes, J., Hardoon, S., Deighton, J., Viding, E., & Osborn, D. (2022). Association between quetiapine use and self-harm outcomes among people with recorded personality disorder in UK primary care: A self-controlled case series analysis. Journal of Psychopharmacology.


Chicago/Turabian   Click to copy
Hayes, J., S. Hardoon, J. Deighton, E. Viding, and D. Osborn. “Association between Quetiapine Use and Self-Harm Outcomes among People with Recorded Personality Disorder in UK Primary Care: A Self-Controlled Case Series Analysis.” Journal of Psychopharmacology (2022).


MLA   Click to copy
Hayes, J., et al. “Association between Quetiapine Use and Self-Harm Outcomes among People with Recorded Personality Disorder in UK Primary Care: A Self-Controlled Case Series Analysis.” Journal of Psychopharmacology, 2022.


BibTeX   Click to copy

@article{j2022a,
  title = {Association between quetiapine use and self-harm outcomes among people with recorded personality disorder in UK primary care: A self-controlled case series analysis},
  year = {2022},
  journal = {Journal of Psychopharmacology},
  author = {Hayes, J. and Hardoon, S. and Deighton, J. and Viding, E. and Osborn, D.}
}

Abstract

Background: Quetiapine is frequently prescribed to people with personality disorder diagnoses, but this is not supported by evidence or treatment guidelines. Aims: To examine associations between periods of quetiapine prescribing and self-harm events in people with personality disorder. Method: Self-controlled case series using linked primary care and hospital records covering the period 2007–2017. We calculated incidence rates and incidence rate ratios (IRRs) for self-harm events during periods when people were prescribed (exposed to) quetiapine, as well as periods when they were unexposed or pre-exposed to quetiapine. Results: We analysed data from 1,082 individuals with established personality disorder diagnoses, all of whom had at least one period of quetiapine prescribing and at least one self-harm episode. Their baseline rate of self-harm (greater than 12 months before quetiapine treatment) was 0.52 episodes per year. Self-harm rates were elevated compared to the baseline rate in the month after quetiapine treatment was commenced (IRR 1.85; 95% confidence interval (CI) 1.46–2.34) and remained raised throughout the year after quetiapine treatment was started. However, self-harm rates were highest in the month prior to quetiapine initiation (IRR 3.59; 95% CI 2.83–4.55) and were elevated from 4 months before quetiapine initiation, compared to baseline. Conclusion: Self-harm rates were elevated throughout the first year of quetiapine prescribing, compared to the baseline rate. However, rates of self-harm reduced in the month after patients commenced quetiapine, compared to the month before quetiapine was initiated. Self-harm rates gradually dropped over a year of quetiapine treatment. Quetiapine may acutely reduce self-harm. Longer-term use and any potential benefits need to be balanced with the risk of adverse events.


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